Abstract
To assess the clinical features of endobronchial tuberculosis due to lymph node perforation (EBTBLN), we investigated the clinical records of eight patients (1 man and 7 women) retrospectively, who were diagnosed as EBTBLN by bronchoscopic findings from June 1992 to November 1998. All patients were over 65 years old, and two patients had a past history of tuberculosis without chemotherapy. The chief complaints on admission of 7 patients were persistent cough and sputum (bloody sputum). The findings of chest X-ray, including CT, on admission varied greatly with consolidation, infiltration or atelectatic shadows, which were lobular, segmental or of minimum extent, and lower lung field tuberculosis was also seen. However no lymphadenopathy could be detected. The locations of the perforating lymph nodes were as follows : right upper lobe bronchus in 4, left upper lobe bronchus in 1, right truncus intermedius in 2 and left basal bronchus in 1. The bronchoscopic findings were also in the varied : frankly perforating lymph nodes, depositions of black carbonized material in the epithelium, or typical bronchial ulcer formation. The mechanisms of EBTBLN are thought as the reactivation of tuberculous lymphadenitis and perforation into the bronchial lumen. The essential points of early diagnosis are sputum examination of tuberculous bacilli and detailed imaging examinations of the airway, and bronchoscopy is nessesary for the diagnosis of endobronchial tuberculosis.
